What does “Just Culture” mean?

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You’ve heard and seen the term “Just Culture” quite a bit in the past few months. We included it in our Strategic Plan, we’ve discussed it at meetings, and it’s on your screensavers. I invited Dr. Appenheimer to share some comments on what it means for our team.
– Dave

Tim Appenheimer, MD, VP/Chief Medical Officer
Over the next several months you will hear more and more about the concept of a “just culture” at KSB. What does “just culture” mean?
In this case, the word “just” means fair.
This is important: traditionally, in the workplace in the United States, someone who is caught making a mistake is punished. This is called a punitive culture. The natural reaction of an employee making an error is to attempt to hide the error or to distance herself from the mistake in order to avoid being punished.
At the other extreme is a workplace where all mistakes and misadventures are blamed on “the system”. No matter what caused the harm, no one is ever held accountable. This is called a blameless culture.
Somewhere in between a punitive culture and a blameless culture is the just culture.
Have you ever made a mistake? Chances are, it was a slip or a momentary lapse of attention. If someone was harmed by your mistake you felt badly about this. Maybe you lost a few nights’ sleep. You found ways not to make this mistake again. You should be consoled and supported.
Have you ever screwed something up by taking unwise chances? You were texting while driving; you gave a medication to the wrong patient when you skipped the “six rights”… because you were in a hurry. You absolutely did not want anyone to be harmed; your intentions were good, but you took an unjustified risk. This is “at-risk behavior”. You need to be educated and coached so that you can understand how you contributed to this error.
You have probably never come to work with the intent of harming someone. You have probably never continued to carry out at-risk behavior after coaching and education. If you did this, it would be called reckless behavior. You probably agree that reckless behavior should be punished in some way.
In a just (fair) culture, people who make mistakes are supported. People who participate in at-risk behavior are coached (and expected not to repeat the at-risk behavior). Reckless behavior requires a punitive response.
We will learn more about Just Culture in a future edition of the Pulse.

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